Analysis of the vaginal secretion is carried out from time to time to monitor the state of reproductive he alth, if there are complaints of itching and burning in the genital tract, during pregnancy or during menopause. The results allow an objective assessment of the number and percentage of pathogenic and opportunistic microorganisms.
Microflora in the vagina
A smear on the flora in women is an analysis that allows you to assess the likelihood of pathological processes in the reproductive system. In the analysis, squamous epithelial cells, cocci, Dederlein lactobacilli, leukocytes and other microorganisms can be detected. The microflora can be sparse, medium, mixed or abundant. If the microflora in the vagina is poor, then only Dederlein sticks are determined, these are useful lactobacilli.
With an average amount, large colonies of rods and 7-10 leukocytes will fall into the field of view of the laboratory assistant. If it's aboutmixed microflora, in a smear in women 15-30 leukocytes are found, a small number of Dederlein sticks, cocci are spherical pathological bacteria. The result "abundant microflora" means that the inner walls of the vagina are covered with leukocytes in the absence of lactobacilli. This provokes an unpleasant odor and the release of a significant amount of mucus.
Why take a swab for flora
The gynecologist performs a sampling of biological material from the vagina (a swab for the flora) in women in order to identify the presence of pathogenic microflora and determine the presence of pathology. In the absence of complaints, doctors previously recommended taking an analysis annually, but now the American Congress of Obstetricians and Gynecologists has introduced new rules. Pap tests are required between the ages of 21 and 65 every three years.
More often, diagnostic manipulation is performed in the presence of complaints: burning or itching in the vagina, pain in the lower abdomen, changes in the consistency, color or smell of discharge. The analysis should be done during pregnancy, suspicion of the development of gynecological pathologies, menopause. Experts recommend taking a smear after you stop taking hormonal drugs that can affect acid levels, and regularly visit a gynecologist.
Preparing for analysis
One week before vaginal sampling, it is recommended to stop taking antibiotics and other medications that can have a significant impact on the smear result. If it is impossible to refuse the medicine, you need to inform the doctor about it. Per daybefore analysis, douching and treatment with suppositories or vaginal tablets should be stopped.
What can be found in a smear
To diagnose pathological conditions, the doctor will most likely take a smear not only from the vagina, but also from the cervical canal and urethra. Technically, these are completely different procedures, but the material is usually collected only once. During microscopic diagnostics, a laboratory assistant can detect squamous epithelium, mucus, Doderlein sticks, leukocytes in a smear.
The inner surface of the vagina and cervical canal is composed of squamous epithelium. The presence of a large number of cells of this type indicates the possible development of urethritis or vaginitis. A lack of squamous cells indicates insufficient secretion of progesterone, a hormone necessary for successful conception and pregnancy.
Leukocytes are necessary for the body to cope with pathogenic microorganisms. Normally, the number of cells in the vagina does not exceed 10, in the neck - 30. A high concentration of leukocytes most often indicates the presence of an inflammatory process of the reproductive system (vaginitis, cervicitis), accompanied by phagocytosis.
Mucus is produced by the vaginal glands and the cervix. In the smear, the amount of mucus should be moderate. Abundant discharge (the doctor will also evaluate this visually during the examination) may indicate vaginal dysbacteriosis. Doderlein's sticks make up the normal microflora, these are gram-positive cells. Lack of sticks in most casesindicates the development of bacterial vaginosis.
Mixed type
If mixed flora is found in the analysis, what does it mean? The issue is relevant for most women, and therefore special attention should be paid to it. The presence of a mixed type of flora in a smear indicates a balance between normal and pathogenic microorganisms. With this result, squamous epithelium, leukocytes, Doderlein lactobacilli and other types of microorganisms are found in the biological material.
In the absence of an inflammatory process, the number of lactobacilli predominates (approximately 90-95%). The remaining 5% are opportunistic bacteria, which include rods and cocci. Potentially dangerous microorganisms do not harm the body, but as their number increases, the threat of developing pathology increases.
Very high risk of developing diseases with mixed abundant flora in a smear during pregnancy. Bearing a child in general is a special condition of the female body, in which existing chronic diseases may worsen or new problems may appear. It may be necessary to undergo complex treatment to prevent the uncontrolled reproduction of pathogenic agents.
Degrees of flora content
The biological material taken from the vagina is assigned a degree of purity during the analysis. This indicator indicates the presence of pathogens and the level of acidity of the microflora. The first degree is a normal condition in which opportunisticmicroorganisms and lactobacilli are in a state of balance, the permissible limits are not violated. The second degree is the relative norm. At the same time, the percentage of pathogenic bacteria is slightly increased, but does not pose a he alth hazard.
The third degree of purity implies a large amount of mixed flora in the smear. At the same time, the number of opportunistic microorganisms prevails over the Doderlein sticks, which are contained in normal discharges in large quantities. Definitely we are talking about pathology, if the results show a fourth degree of purity of the vagina. This condition is characterized by a predominance of squamous epithelium, pathogenic bacteria and leukocytes.
Ample microflora
Mixed flora in large numbers usually indicates the presence of pathological processes in the uterus. At the same time, a large amount of mucus and squamous epithelium, layers of MPE cells, blood cells, and traces of phagocytosis are found in the biological material during microscopic examination. The pathological condition is treated with vaginal suppositories that inhibit the functioning of pathogens and restore the normal pH level.
Coccobacillary microflora
Mixed flora in small quantities is a pathological condition. If coccobacilli predominate in the smear (something between ordinary cocci and bacilli), then in most cases the gynecologist diagnoses the presence of gardnerella vaginalis, Haemophilus influenzae or chlamydia. Increasing the number of pathogenic agentswill lead to the development of fungal infections, vaginitis and bacterial vaginosis.
Causes of flora disturbance
Scanty mixed flora in a smear can be detected after taking antibacterial drugs that greatly affect the immune system, creating conditions for the development of pathogenic bacteria. The use of hormonal contraceptives can lead to disturbances in the balance of microflora. At the same time, the number of lactobacilli and leukocytes usually increases in the medium.
Women themselves provoke an imbalance by protecting themselves from unwanted pregnancies. Poor smear results for flora are usually obtained by those patients who have installed an intrauterine device. This contraceptive creates an imbalance suitable for the active development of coccobacilli.
Provokes the reproduction of pathogenic microflora and washing out the normal contents of the vagina frequent douching. Therefore, intimate hygiene should be moderate. Enough daily washing with plain water (at least once a day, maximum - after each visit to the toilet or change of hygiene products during menstruation). The vagina is a self-cleaning system, so there is no need for excessive hygiene procedures. It is undesirable to use aggressive means for intimate hygiene. It is better to choose gels with a neutral pH, without dyes and flavors.
Is treatment required
Mixed flora in a smear requires clarification of the diagnosis,because therapy is not required in all cases. In the presence of erosion, cauterization is prescribed, but some forms of the disease do not require medical intervention (only regular monitoring). Gonorrhea, mycoplasmosis, chlamydia, trichomoniasis and similar diseases are treated with special products containing components aimed at combating certain bacteria.
With a slight change in the microflora, a course of vaginal suppositories or ointments is enough. After the end of treatment, you need to pass the analysis again. If the results again reveal pathological microorganisms in large numbers and mixed flora in the smear (in women, this may be a consequence of taking certain medications), you may need to undergo therapy with stronger drugs.
The gynecologist may recommend additional examinations to the patient, which will eliminate the possibility of a misdiagnosis (re-analysis after certain preparation, for example, the end of a course of antibiotics or the refusal of hormonal contraceptives, ultrasound of the pelvic organs, analyzes of biological fluids, etc.). It is better to immediately listen to the advice of a doctor in order to immediately clarify the diagnosis.
Features during pregnancy
Mixed microflora is often found in a smear in pregnant women. Women in position pass this analysis at least three times: when issuing an exchange card and registering, for up to thirty weeks and in the third trimester, shortly before childbirth, that is, at thirty-six to thirty-sevenweeks. Sometimes there may be a need for an additional examination: if there are complaints of itching, changes in the amount, smell or consistency of discharge, burning sensation.
A successful sign of conception before a missed period is a change in the nature of the vaginal discharge. During implantation, immunity is slightly reduced, because the fetal egg is often perceived by the body as a foreign object. Pregnant women often experience thrush. It is important to get rid of the symptoms of this disease before delivery, because the child can become infected when passing through the mother's genital tract.
If mixed flora is associated with serious medical conditions, the doctor may recommend terminating the pregnancy. The fact is that many drugs are prohibited during the period of gestation, and the lack of therapy can lead to intrauterine infection and death of the embryo. Therefore, experts recommend taking an analysis and undergoing treatment at the stage of pregnancy planning.
Any pathology is much easier to prevent than eliminate (especially if you have to be treated during pregnancy). Mixed flora in a smear in women is no exception. Do not forget about the prevention of diseases of the reproductive system and regularly visit a gynecologist. Compliance with simple rules will not only prevent gynecological diseases, but also bear a he althy baby.
